Somatostatin attenuates intestinal epithelial barrier injury during acute intestinal ischemia–reperfusion through Tollip/Myeloiddifferentiationfactor 88/Nuclear factor kappa-B signaling

ABSTRACT In the process of ischemia–reperfusion injury, intestinal ischemia and inflammation interweave, leading to tissue damage or necrosis. However, oxygen radicals and inflammatory mediators produced after reperfusion cause tissue damage again, resulting in severe intestinal epithelial barrier dysfunction. The aim of this study was to determine the protective effect of somatostatin on intestinal epithelial barrier function during intestinal ischemia–reperfusion injury and explore its mechanism. By establishing a rat intestinal ischemia–reperfusion model, pretreating the rats with somatostatin, and then detecting the histopathological changes, intestinal permeability and expression of tight junction proteins in intestinal tissues, the protective effect of somatostatin on the intestinal epithelial barrier was measured in vivo. The mechanism was determined in interferon γ (IFN-γ)-treated Caco-2 cells in vitro. The results showed that somatostatin could ameliorate ischemia–reperfusion-induced intestinal epithelial barrier dysfunction and protect Caco-2 cells against IFN-γ-induced decreases in tight junction protein expression and increases in monolayer cell permeability. The expression of Tollip was upregulated by somatostatin both in ischemia–reperfusion rats and IFN-γ-treated Caco-2 cells, while the activation of TLR2/MyD88/NF-κB signaling was inhibited by somatostatin. Tollip inhibition reversed the protective effect of somatostatin on the intestinal epithelial barrier. In conclusion, somatostatin could attenuate ischemia–reperfusion-induced intestinal epithelial barrier injury by inhibiting the activation of TLR2/MyD88/NF-κB signaling through upregulation of Tollip.


Introduction
In a variety of clinical conditions, such as arterial embolism, strangulation hernia, colon cancer, volvulus, blood poisoning and mesenteric sexual dysfunction and hypovolemic shock, which can lead to intestinal ischemic injury and are often accompanied by tissue reperfusion after ischemia, reperfusion can aggravate intestinal damage, the process of the pathological process known as intestinal ischemia-reperfusion injury (I/RI) [1]. This process is often accompanied by inflammation. There is an interaction between ischemia and hypoxia and the inflammatory response, which can reduce the survival rate of patients with ischemic intestinal injury. The release of inflammatory factors leads to damage to intestinal mucosal barrier function, which allows bacteria and endotoxin in the intestinal cavity to translocate to the circulatory system through the damaged intestinal mucosal barrier and thus induces systemic inflammatory response syndrome (SIRS) and even multiple organ failure (MOF) [2,3]. The intestinal epithelial barrier (IEB) is composed of mechanical, immune, biological and chemical barriers [4]. The mechanical barrier is the structural basis of intestinal mucosal barrier function and is composed of epithelial cells and adjacent cells [5]. Tight junction (TJ) protein is a multiprotein complex composed of Occludin, Claudins, the ZO family and junction adhesion molecule (JAM). Among them, ZO-1 and Occludin proteins play an important role in tight junctions, and changes in the expression and distribution of ZO-1 and Occludin directly lead to damage to the intestinal epithelial mechanical barrier [4,6].
Although the specific mechanism of intestinal mucosal barrier function damage caused by intestinal I/RI remains unclear, it can be confirmed that I/RI can cause hypoxia and an inflammatory response in the intestinal mucosa and cause IEB damage by stimulating inflammatory cells to release a large amount of inflammatory factors, such as interferon gamma, lipopolysaccharide (LPS) [7], and interleukins (ILs) [8]. Previous studies have confirmed that inflammatory and hypoxic stimulation can activate intestinal epithelial lymphocytes (IELs) and increase the secretion of IFN-γ by IELs in the process of intestinal I/RI, and IFN-γ plays an important regulatory role in the process of IEB function injury [9][10][11][12]. IFN-γ is currently recognized as an inflammatory factor that can cause IEB dysfunction by mediating apoptosis of intestinal epithelial cells (IECs) and affecting the expression and distribution of TJ proteins (such as downregulating the expression of the TJ proteins ZO-1 and Occludin) [13][14][15]. IFN-γ can activate NF-κB, induce MLCK-mediated myosin light chain (MLC) phosphorylation, adjust the cytoskeleton, open TJs, increase the permeability of the intestinal mucosal barrier, and then damage the IEB [16][17][18]. Fortunately, somatostatin (SST) was reported to inhibit the production of IFN-γ in IECs during intestinal I/RI [19] and inhibit intestinal I/RI by inhibiting the TLR4/NF-κB pathway [20]. Somatostatin (SST) is a neurotransmitter and immunomodulatory peptide widely distributed in neurons of the central nervous system and endocrine organs, including the gastrointestinal tract. At the same time, studies have shown that SST plays an important role in regulating the immune response, including inhibiting the proinflammatory response of neutrophils, macrophages and lymphocytes. It promotes the development and maintenance of the Th2 response and reduces Th17 and Th1-like cytokines [21,22]. Moreover, SST can directly regulate the intestinal inflammatory response as an anti-inflammatory peptide [23]. There are also studies that show that SST has a protective effect on IFN-γ-mediated IEB injury during intestinal I/RI, and its possible mechanism is unclear.
Toll-like receptors (TLRs), a family of transmembrane proteins, have a central role in the initiation of innate immunity against invading microbial pathogens and have recently been recognized as one of the main contributors to injury-induced inflammation [24]. Accumulating evidence has shown that TLRs play an important role in the innate host defense and maintenance of mucosal homeostasis in healthy intestinal mucosa [25]. Under homeostatic conditions, low concentrations of TLR2 and TLR4 are expressed in healthy intestinal mucosa [26], and the normal expression of TLR2 and TLR4 plays an essential role in protecting intestinal mucosa from exogenous injury [27]. Furthermore, MyD88 is a universal adaptor protein involved in TLR-induced NF-κB activation [28,29]. Toll-interacting protein (Tollip) is a multitask intracellular adapter protein that interacts with interleukin (IL) IL-1B, IL-13, Tolllike receptor 2 (TLR2) and 4, and transcriptional growth factor-B (TGF-B) pathways [30]. Tollip is also associated with innate immunity as an inhibitor of inflammation and ER stress, an activator of autophagy, or a key regulator of intracellular vacuolar transport [31]. Tollip and MyD88 are key components of the TLR signaling pathway in mammals, while previous studies have demonstrated that Tollip serves as a negative regulator of MyD88-induced NF-κB activation [32]. Whether Tollip and TLR/ MyD88/NF-κB signaling are involved in the protective effect of SST on IEB dysfunction induced by intestinal I/RI remains unclear.
In this study, we aimed to determine whether somatostatin (SST) has a protective effect on the intestinal epithelial barrier during ischemia-reperfusion injury and IFN-γ-induced Caco-2 cells. We hypothesized that SST has a protective effect and inhibits the TLR/MyD88/MLCK signaling pathway by upregulating Tollip expression. Our work may reveal the important role of SST in alleviating intestinal I/RI and elucidate a novel molecular mechanism.
For IFN-γ treatment, Caco-2 cells were incubated in DMEM and 100 U/mL IFN-γ (Sigma-Aldrich; USA) for 48 h. In addition, somatostatin (SST; Sigma-Aldrich; USA) was dissolved in DMEM and added to the culture medium of Caco-2 cells at an experimental concentration of 1 μM 2 h before IFN-γ treatment.

Intestinal epithelial barrier function determination
Caco-2 cells transfected with or without siTollip were seeded in the upper chamber of a Transwell chamber (Corning; USA) with a polyethylene terephthalate membrane (0.33 cm 2 ; 0.4 mm pore size) at a density of 1.0 × 10 6 cells/well. When the cells reached confluence and completely differentiated, IFN-γ and/or SST was added to the apex of the filter as described above. The transepithelial electrical resistance (TER) of filter-grown Caco-2 monolayers was measured repeatedly at three different locations using a Millicell-ERS system (Millipore; USA) according to a previous report [33]. The change in TER was expressed as a percentage of the corresponding basal value.
To detect the permeability of the epithelium across Caco-2 cell monolayers, 1 mg/mL FITClabeled dextran of molecular mass 4 kDa (FD4; Sigma-Aldrich; USA) was added to the apical chamber of Transwell inserts at the end of IFN-γ and SST treatment, and the cells were further cultured for 2 h. Then, the fluorescence intensity of FITC was detected by a fluorescence plate reader (BioTek; USA) at 492 nm excitation and 520 nm emission. This detection was performed according to a previous study [33].

Immunofluorescence staining
Caco-2 cells were cultured on coverslips until confluence and cultured under various experimental conditions. After treatment, the cells were washed three times with PBS solution and then fixed with 4% paraformaldehyde at room temperature for 10 min. Then, the cells were infiltrated with 0.1% Triton X-100 for 5 min and blocked with 3% BSA for 1 h at room temperature. Subsequently, the Caco-2 cells were incubated with rabbit anti-ZO -1 antibody (1:100; ab221547; Abcam; UK) and rabbit anti-Occludin antibody (1:100; ab216327; Abcam; UK) at 4°C overnight, and then the coverslips were washed and incubated with Alexa Fluor 488 goat anti-rabbit IgG (1:1000; ab150077; Abcam; UK) antibody in the dark at room temperature for 40 min. Finally, the cells were restained with 4', 6-diamino-2-phenylindole (DAPI) (Beyotime; China) at room temperature for 5 minutes and observed with a fluorescence microscope (×400; Olympus; Japan).

Animal model
A total of 50 adult male SD rats (aged 6-8 weeks; weighing 200-250 g) were obtained from the Experimental Animal Center of Kunming Medical University (Certificate number: SCXK (Dian) K2020-0004) and housed individually with a 12-h light/dark cycle at 22°C with 50% humidity and received ad libitum food and water. All animal experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Kunming Medical University (Approval No. kmmu20211340).
The rat acute intestinal ischemia-reperfusion models were established according to previously described methods [34]. Following a 12-h fasting period, ischemia was induced for 1 h by occluding the superior mesenteric artery (SMA) with a microvascular clamp under anesthesia by intraperitoneal injection with 1% sodium pentobarbital (30 mg/kg). When the ischemia period was over, the microvascular clamp was removed, and the animals were allowed 6 h of reperfusion.

RT2 profiler PCR array gene expression analysis
To determine the change in the inflammatory response and autoimmunity-related gene expression during intestinal I/RI, rats from the sham group, I/RI group and I/RI+SST group (n = 6 per group) were subjected to narcotic overdose, and then jejunal tissues were obtained at a distance of 10 cm from the Trize ligament after 6 h of reperfusion. The total RNA of jejunal tissues was extracted using TRIzol reagent (Invitrogen; CA), and then the expression of inflammatory response-and autoimmunity-related genes was detected by RT 2 Profiler PCR Arrays (RARN-077Z; QIAGEN; China) according to the manufacturer's instructions and the PCR Array System protocol.

H&E staining of intestinal tissue sections
Six hours after reperfusion, the rats were anesthetized by overdose until death, and the intestine tissues were collected and fixed in 4% paraformaldehyde overnight at room temperature. The tissues were dehydrated with a series of ethanol (75% ethanol for 2 h; 80% ethanol for 2 h; 95% ethanol I for 2 h; 95% ethanol II for 1.5 h; 100% ethanol I for 1 h; 100% ethanol II for 30 min) at room temperature, embedded in paraffin, and sectioned into 5-μm slices for H&E staining. H&E staining was performed by the H&E Staining Kit according to the manufacturer's instructions. All slices were imaged using a light microscope (x200; Olympus; Japan).

Immunofluorescence analysis of intestinal tissue sections
Paraffin sections of intestinal tissues were stained with rabbit anti-ZO-1 antibody (1:100; ab221547; Abcam; UK) and rabbit anti-Occludin antibody (1:100; ab216327; Abcam; UK) according to a previous report [35]. In brief, the tissue slices were incubated with the respective primary antibody overnight at 4°C after antigen repair and 3% BSA blocking. Then, the tissue slices were incubated with Alexa Fluor 488 goat anti-rabbit IgG secondary antibody (1:1000; ab150077; Abcam; UK) for 50 min at room temperature. After 3 washes with PBS (0.01 M; pH 7.4), the slides were incubated with DAPI in the dark at room temperature for 10 min and then sealed. The sections were observed and imaged under a fluorescence microscope (×100; Olympus; Japan).

FITC-dextran detection
The intestinal permeability of the rat was measured by FITC-dextran permeability according to previously described methods [36]. After 2 h of reperfusion, the rats were administered FITCdextran via intragastric infusion (60 mg/100 g BW; 20 mg/ml). Four hours later, blood samples were collected from the eyeballs of the rats after anesthetization and centrifuged at 3000 g for 10 min at 4°C. FITC was measured in 100 μL of serum by using the standard curve of FITCdextran in serum by a fluorescence plate reader (BioTek; USA) (excitation, 480 nm; emission, 525 nm).

ELISA
After 6 h of reperfusion, the rats were anesthetized, and blood samples were collected from the eyeballs of the rats. Serum was obtained by centrifuging at 3000 g for 10 min at 4°C. The contents of the proinflammatory cytokines IFN-γ (mlbio; Shanghai; China) and TNF-α (mlbio; Shanghai; China) in serum were determined by ELISA kits following the manufacturer's instructions.

Statistical analysis
All the data were presented as the mean ± SD. Two-tailed Student's t tests were carried out for two-group comparisons. One-way analysis of variance (ANOVA) or two-way ANOVA followed by the Bonferroni post hoc test was used to assess differences between more than two groups. Statistical analyses were performed with GraphPad Prism 7.0 software (GraphPad Software, Inc.). P < 0.05 indicated a statistically significant difference.

Results
Here, we aimed to explore the protective effect and molecular mechanism of SST on intestinal epithelial barrier injury during intestinal ischemiareperfusion. Caco-2 cells were induced by IFN-γ, and a rat intestinal ischemia-reperfusion model was established. The cells or rats were treated with SST to detect the degree of cell tight junction damage and to detect the histopathological changes, intestinal permeability and expression of tight junction proteins in the intestinal tissues of rats. The results showed that SST exerted a protective effect by upregulating the expression of Tollip in ischemia-reperfusion rats and IFN-γinduced Caco-2 cells and inhibiting the activation of the TLR2/MyD88/NF-κB signaling pathway.

SST attenuated I/RI-induced inflammation and intestinal epithelial barrier injury
To verify whether SST has a protective effect on intestinal epithelial barrier injury induced by intestinal ischemia-reperfusion (I/R), a rat intestinal I/R injury (IIRI) model was established, and SST was intraperitoneally injected at a dosage of 10 mg/kg BW 30 min before ischemia. After 6 h of reperfusion, the histopathological changes and inflammatory response of rat intestinal tissues were detected. As Figure 1(a) shows, the intestinal mucosa was intact and the villi were arranged in order in the sham group, while the intestinal epithelial barrier was severely damaged, and intestinal villi were disorganized and broken with obvious inflammation in the I/RI group. SST treatment alleviated I/RI-induced intestinal epithelial injury, and the intestinal epithelial barrier structure was basically intact. Meanwhile, the expression of the main TJ proteins ZO-1 and Occludin was inhibited by I/RI but upregulated by SST (Figure 1(b)), and the levels of the inflammatory cytokines IFN-γ and TNF-α in rat serum were obviously increased by I/RI induction,but the damage caused by I/RI was partially reversed after SST treatment. (Figure 1(c,d)). These results showed that intraperitoneal injection of SST could protect the intestinal epithelial barrier and inhibit the inflammatory response induced by I/RI.
In addition, RT 2 Profiler PCR Arrays were used to determine inflammation-and autoimmunityrelated gene expression in intestinal tissues during I/RI and SST treatment. As the results showed (Figure 1(e)), the expression levels of a number of genes were changed, especially genes related to TLR signaling. In the TLR family, the expression levels of TLR1, TLR2, TLR5, TLR6, and TLR7 were significantly upregulated by I/RI induction but obviously decreased by SST treatment. Additionally, the expression levels of MyD88 and Nfkb1, which are inflammatory factors downstream of TLR, were increased in the I/RI group and downregulated by SST. In contrast, the expression of Tollip, which can inhibit the activation of TLR signaling, was significantly inhibited by I/RI and upregulated by SST treatment. These results indicated that SST could regulate inflammatory gene expression, and the protective mechanism of SST on intestinal epithelial injury after I/RI is related to Tollip/TLR/MyD88 signaling.

SST inhibited IFN-γ-induced Caco-2 cell tight junction damage
In the cell experiments, the effect of IFN-γ on the tight junctions of Caco-2 cells was first determined. As Figure S1 shows, IFN-γ decreased the transepithelial resistance (TER) of Caco-2 monolayer cells, increased the FITC-dextran permeability of Caco-2 monolayer cells, and inhibited the expression of ZO-1 and Occludin. Then, IFN-γ-treated Caco-2 cells were used as an intestinal I/RI epithelial inflammatory cell model for subsequent cell experiments.
To detect the effect of SST on IFN-γ-induced Caco-2 cells, cells were pretreated with SST (1 μM) 2 h before IFN-γ treatment, and then tight junction and Tollip/TLR2/MyD88 expression in Caco-2 cells was measured. As the results showed, SST could effectively reverse the decrease in TER and the increase in FITC-dextran permeability of Caco-2 cell monolayers mediated by IFN-γ treatment (Figure 2(a,  b)). Western blotting and immunofluorescence staining showed that SST obviously upregulated the expression of ZO-1 and Occludin, which were inhibited by IFN-γ treatment (Figure 2(c,d)). These results showed that SST could protect against the tight junction damage of Caco-2 cells induced by IFN-γ.

SST inhibited IFN-γ-induced Caco-2 cell TLR2/ MyD88/NF-κB signaling activation
Furthermore, there was a significant activation of TLR2/MyD88/NF-κB signaling in Caco-2 cells of the IFN-γ-treated group. The expression of TLR2 was obviously upregulated by IFN-γ but inhibited by SST treatment (Figure 3(a,b)), and the expression of the downstream targets of TLR2, MyD88, IRAK1, p-65, and MLCK, was increased, or their phosphorylation was stimulated by IFN-γ treatment but reversed by SST (Figure 3(a, d-i)). In contrast, the expression of Tollip was downregulated by IFN-γ but upregulated by SST treatment (Figure 3(a,c)). These results showed that SST could inhibit the activation of TLR2/MyD88/NF-κB signaling induced by IFN-γ and induce the expression of Tollip, which acted as an inhibitor in TLR2/MyD88/NF-κB signaling. These results indicated that SST may inhibit IFN-γ-induced Caco-2 cell tight junction damage by upregulating Tollip and inhibiting the activation of TLR2/ MyD88/NF-κB signaling.

SST alleviated IFN-γ-induced Caco-2 cell tight junction damage by upregulating Tollip
To further verify the role of Tollip, Tollip siRNA (siTollip) was used for Tollip inhibition. In total, three siRNAs were used for transfection, and the inhibitory efficiency was detected by Western blotting (see Figure S1(a)). The most effective siRNA (ssiTollip-1) was used for further study. The results showed that inhibition of Tollip aggravated the tight junction damage induced by IFN-γ ( Figure 4). siTollip further aggravated the decrease in TER and the increase in FITC-dextran permeability of Caco-2 monolayer cells induced by IFNγ and weakened the protective effect of SST (Figure 4(a,b)). The expression and activation of MyD88/NF-κB/MLCK signaling in IFN-γ-treated Caco-2 cells were increased by siTollip, and the inhibition of MyD88/NF-κB/MLCK signaling in SST-pretreated Caco-2 cells was also obviously reversed by Tollip inhibition (Figure 4(c)). As Figure 4(d,e) show, the expression levels of ZO-1 and Occludin were significantly downregulated by siTollip in both IFN-γ-and SST-pretreated Caco-2 cells. These results suggested that Tollip played an important role in the protective effect of SST on IFN-γ-induced tight junction damage in Caco-2 cells and indicated that SST protected the epithelial barrier function of Caco-2 monolayer cells against IFN-γ-induced damage by upregulating Tollip expression.

SST inhibited MyD88/NF-κB/MLCK signaling in rat intestines via Tollip
In addition, the expression and activation of MyD88/NF-κB/MLCK signaling in I/RI rat intestinal tissues was obviously inhibited by SST pretreatment but further stimulated by Tollip inhibition (Figure 6). Western blotting showed that the protein expression of Tollip in I/RI rats was upregulated by SST pretreatment and inhibited by siTollip, while the upregulation of Tollip by SST was also significantly reversed by Tollip inhibition ( Figure 6(a,b)). Furthermore, the expression of MyD88, p-p65 and MLCK in I/RI rats was significantly inhibited by SST but stimulated by siTollip. Tollip inhibition weakened the downregulation of the expression of MyD88, p-p65 and MLCK mediated by SST pretreatment (Figure 6(a, c-e)). These results proved that SST could inhibit the activation of MyD88/NF-κB/MLCK signaling by upregulating the expression of Tollip.

Discussion
Intestinal ischemia is usually caused by arterial occlusion mediated by thrombosis or embolisms and more commonly by nonocclusive processes, such as low mesenteric flow in cardiac insufficiency and sepsis [37,38]. Although reperfusion is necessary for the survival of tissues, it may trigger the release of many proinflammatory mediators and aggravate organ injury [39,40]. I/RI can induce an intestinal inflammatory response and secrete a large number of inflammatory factors and endotoxins, thus activating the NF-κB/MLCK signaling pathway, causing the destruction of tight junctions in intestinal epithelial cells and leading to IEB dysfunction [2,3,41]. In this study, we confirmed that somatostatin (SST) pretreatment could protect IEB against I/RI-induced dysfunction. The mechanism was related to Tollip/MyD88/NF-κB signaling-mediated inflammation and loss of TJ protein expression.
The tight junction of IECs is the main structure of the epithelial mechanical barrier; therefore, the normal expression and distribution of TJ proteins are essential to maintain the integrity of the intestinal epithelial mechanical barrier. The activation of NF-κB/MLCK signaling was reported to be related to abnormal expression of TJ proteins and increased permeability of the epithelial barrier [41,42]. Proinflammatory cytokines, such as TNF-α and IFN-γ, can lead to the destruction of TJ protein structure and a decrease in TJ protein expression by activating the NF-κB/MLCK signaling pathway [9,43]. Previous studies showed that SST could inhibit the inflammatory response of intestinal mucosa and IECs [44,45] and inhibit the activation of TLR4/NF-κB signaling [20]. TLR signaling plays an essential role in I/RIinduced intestinal mucosa inflammation and IEB dysfunction, and MyD88 acts as a universal adaptor protein involved in TLRinduced NF-κB activation [28,29]. Among the TLR family members, TLR2 and TLR4 are most closely related to the tissue injury caused by the MyD88/NF-κB signaling-mediated inflammatory response after ischemia-reperfusion [24]. Research has shown that normal expression of TLR2 is a protective factor in maintaining the innate immune response and mounting a protective acquired immune response [46,47]. However, the role of TLR2 in intestinal I/RI remains controversial. Persistent high-level expression and activation of TLR2 after injury will lead to the production of TNF-α and activation of NF-κB [48], which are both proinflammatory factors. Some other studies suggested that the expression of TLR2 was an unbeneficial factor during I/RI [49]. In this study, TLR2/ MyD88/NF-κB signaling was found to be highly expressed and activated in intestinal tissues of I/ RI rats, and SST pretreatment significantly downregulated the level of TLR/MyD88/NF-κB (see Figure 1(e)). Tollip is an important negative regulator in TLR signaling and can negatively regulate the activation of MyD88-induced NF-κB signaling [32]. However, the role of Tollip in intestinal I/RI remains unclear. In this study, the expression of Tollip was observed to be decreased in I/RI rats and increased by SST pretreatment. Furthermore, it was determined that Tollip protected against intestinal I/RI and alleviated I/RI-induced IEB dysfunction by inhibiting the activation of MyD88/NF-κB/MLCK The relative protein levels measured by ImageJ software. (f) Summary of this study. I/RI, intestinal I/R injury group; I/RI/SST, I/RI with SST pretreatment; I/RI/siTollip, I/RI with siTollip injection; I/RI/SST/siTollip, I/RI with SST pretreatment and siTollip injection. n = 5 per group. One-way ANOVA followed by Bonferroni post hoc test was used to compare the differences among different groups, 'ns' indicated no significance. ns P>0.05, *P < 0.05, ***P < 0.001, ****P < 0.0001 vs. I/RI group; #### P < 0.0001 vs. I/RI/SST group; @@ P < 0.01, @@@ P < 0.001, @@@@ P < 0.0001 vs. I/RI/siTollip group.
signaling. SST could also protect the integrity and functions of IEB by upregulating the expression of Tollip during intestinal I/RI.

Conclusions
In summary, SST plays a protective role in epithelial barrier function after intestinal ischemia-reperfusion injury, and Tollip may be a potential therapeutic target for epithelial barrier injury after intestinal I/RI. By upregulating the expression of Tollip, SST inhibited the activation of MyD88/NF-κB/MLCK signaling and protected the structural integrity and function of the intestinal epithelial barrier during intestinal ischemia-reperfusion injury. Although this study has some limitations due to the imperfect experimental design, the results of this study can provide a new potential therapeutic target for intestinal barrier injury caused by intestinal ischemiareperfusion.

Ethics statement
All experimental mouse protocols were approved by the Animal Ethics Committee of the First Affiliated Hospital of Kunming Medical University (Approval No. kmmu20211340), and the animals were handled according to the management requirements of the Animal Management Association of the First Affiliated Hospital of Kunming Medical University.

Disclosure statement
No potential conflict of interest was reported by the author(s).

Funding
The study was supported by Yunnan Basic Research Project of Kunming Medical Joint Special Project, [2018FE001-035].